Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique

Guiu, Boris; Chevallier, P.; Denys, Alban; Delhom, E.; Pierredon-Foulongne, Marie-Ange; Rouanet, Philippe; Fabre, Jean‐Michel; Quénet, François; Herrero, Astrid; Panaro, Fabrizio; Baudin, G.; Ramos, Jeanne

doi:10.1007/s00330-016-4291-9

Cited by 155 publications

(188 citation statements)

References 31 publications

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“…32 53,54 Finally, sequential ipsilateral hepatic vein embolization after PVE has been reported to result in a greater FLR increase compared with PVE alone. [55][56][57][58][59] According to the largest series including 12 patients, the mean proportion of FLR/total liver volume was 39.7% ± 0.6% 1 to 2 weeks after PVE, and 44.2% ± 1.1% 2 weeks after hepatic vein embolization.…”

Section: Technical Refinements For Increasing Flrmentioning

confidence: 99%

Dealing with an insufficient future liver remnant: Portal vein embolization and two‐stage hepatectomy

Kawaguchi

Lillemoe

Vauthey

2019

Journal of Surgical Oncology

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Colorectal liver metastases (CLM) are not always resectable at the time of diagnosis. An insufficient future liver remnant is a factor excluding patients from curative intent resection. To deal with this issue, two‐stage hepatectomy was introduced approximately 20 years ago. It is a sequential treatment strategy for bilateral CLM, which consists of preoperative chemotherapy, portal vein embolization, and planned first and second liver resections. This study reviews current evidence supporting use of two‐stage hepatectomy.

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Section: Technical Refinements For Increasing Flrmentioning

confidence: 99%

Dealing with an insufficient future liver remnant: Portal vein embolization and two‐stage hepatectomy

Kawaguchi

Lillemoe

Vauthey

2019

Journal of Surgical Oncology

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“…The technique involves RPVE and embolization of the right and/or middle hepatic vein during the same procedure. An initial pilot study involving 7 patients by Guiu et al [44 ]reported an FLR increase from 28.2% (range 22.4-33.3%) to 40.9% (range 33.6-59.3%) at 23 days following LVD. In a follow-up study of 10 patients, FLR volume increased by 53.4% as early as 7 days following LVD.…”

Section: Options To Improve Future Liver Remnant Hypertrophymentioning

confidence: 99%

“…2 patients experienced interval disease progression, and 1 patient had insufficient FLR hypertrophy. No patients who underwent surgery developed postoperative liver failure [44,45,46]. While these early results with LVD are encouraging, comparison studies are necessary to evaluate the additional benefit provided by simultaneous PVE and HVE.…”

Section: Options To Improve Future Liver Remnant Hypertrophymentioning

confidence: 99%

Portal Vein Embolization: State-of-the-Art Technique and Options to Improve Liver Hypertrophy

Huang

Aloia

2017

Visc Med

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Portal vein embolization (PVE) is associated with a high technical and clinical success rate for induction of future liver remnant hypertrophy prior to surgical resection. The degree of hypertrophy is variable and depends on multiple factors, including technical aspects of the procedure and underlying chronic liver disease. For patients with insufficient liver volume following PVE, adjunctive techniques, such as intra-portal administration of stem cells, dietary supplementation, transarterial embolization, and hepatic vein embolization, are available. Our purpose is to review the state-of-the-art technique associated with high-quality PVE and to discuss options to improve hypertrophy of the future liver remnant.

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“…The potential benefit of LVD as compared to PVE is more massive and rapid hypertrophy, similar to ALPPS. Guiu et al 5 reported on a series of 7 patients who underwent LVD, with technical success achieved in all patients. FLR was reported to increase from 28.2% (22.4%–33.3%) to 40.9% (33.6%–59.3%%) over a 23-day period.…”

Section: Techniques For Liver Regenerationmentioning

confidence: 99%

Portal vein embolization for induction of selective hepatic hypertrophy prior to major hepatectomy: rationale, techniques, outcomes and future directions

Madoff

2016

Cancer Biology & Medicine

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The ability to modulate the future liver remnant (FLR) is a key component of modern oncologic hepatobiliary surgery practice and has extended surgical candidacy for patients who may have been previously thought unable to survive liver resection. Multiple techniques have been developed to augment the FLR including portal vein embolization (PVE), associating liver partition and portal vein ligation (ALPPS), and the recently reported transhepatic liver venous deprivation (LVD). PVE is a well-established means to improve the safety of liver resection by redirecting blood flow to the FLR in an effort to selectively hypertrophy and ultimately improve functional reserve of the FLR. This article discusses the current practice of PVE with focus on summarizing the large number of published reports from which outcomes based practices have been developed. Both technical aspects of PVE including volumetry, approaches, and embolization agents; and clinical aspects of PVE including data supporting indications, and its role in conjunction with chemotherapy and transarterial embolization will be highlighted. PVE remains an important aspect of oncologic care; in large part due to the substantial foundation of information available demonstrating its clear clinical benefit for hepatic resection candidates with small anticipated FLRs.

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Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique

Cited by 155 publications

References 31 publications

Dealing with an insufficient future liver remnant: Portal vein embolization and two‐stage hepatectomy

Dealing with an insufficient future liver remnant: Portal vein embolization and two‐stage hepatectomy

Portal Vein Embolization: State-of-the-Art Technique and Options to Improve Liver Hypertrophy

Portal vein embolization for induction of selective hepatic hypertrophy prior to major hepatectomy: rationale, techniques, outcomes and future directions

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